How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $190.55 Median $3,162.28 Typical High $7,762.47 | Facility | None | $190.55 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $194.98 | Professional | None | $131.83 | $165.96 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $275.42 | Professional | None | $134.90 | $141.25 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $213.80 Typical High $416.87 | Professional | 50 · Both sides | $199.53 | $213.80 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $190.55 | Professional | None | $114.82 | $158.49 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $1,659.59 | Facility | None | $169.82 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $309.03 | Professional | None | $123.03 | $154.88 | $309.03 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $660.69 Typical High $12,022.64 | Facility | None | $134.90 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $954.99 Typical High $1,479.11 | Professional | None | $204.17 | $954.99 | $1,479.11 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $281.84 | Professional | None | $147.91 | $204.17 | $281.84 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $97.72 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $91.20 | $112.20 | $134.90 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 24th of 51
$214
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.